Blue cohosh or Caulophyllum thalictroides is a perennial herb native to the Eastern region of North America. The herb was used extensively by the Native Americans as part of a large herbal pharmacopoeia which was used to address a wide variety of conditions. Early European explorers were introduced to blue cohosh when they first reached the United States, and many of them found the herb helpful, especially for gynecological health problems. Blue cohosh is not related to black cohosh, an herb in an entirely separate botanical grouping.

In the wild, blue cohosh can grow up to three feet (one meter) tall, with yellow green to purplish flowers which develop into dark blue-black berries. The leaves are ternately compound, meaning that each leaf has three distinct leaflets. The part of the plant which is used is the root, which may be dried and ground up or used to create tinctures and herbal preparations. Like many herbal remedies, the strengths of these preparations vary, depending on how they are prepared and the particular plants used to create them. As a result, dosage recommendations for blue cohosh may vary.

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The herb appears to have a number of functions. During childbirth, it can ease the spasms of uterine contractions, making the laboring mother more comfortable. In women who are not pregnant, it can stimulate menstrual flow, and in people of all genders it is used as a diuretic and to help break fevers. Blue cohosh has a large number of minerals which may interact with compounds in the plant to bring about these effects; because it is used so often for gynecological issues, blue cohosh is sometimes called the “woman's friend,” and it is also known as squaw root.

People who have been diagnosed with stomach complaints such as ulcers or acid reflux syndrome should avoid blue cohosh, as should people with heart problems and high blood pressure. Blue cohosh is also not recommended for pregnant woman unless they are under medical supervision, as it can stimulate premature labor. Like other herbal remedies, blue cohosh can also interfere with some prescription medications, and it is a very good idea to consult a doctor before using the drug.

A high concentration of alkaline minerals can make blue cohosh unsafe for long term use, which is usually defined as three months or more. The herb can also cause intestinal discomfort and it has been associated with liver disease. If signs of health problems appear after a patient takes blue cohosh, he or she should discontinue use of the drug immediately.

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